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Posted - 05/18/2007 : 11:46:01
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Dear Members,
The following important research studies can be found at PubMed:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=PubMed&term=flupenthixol/therapeutic+use[MAJR]&dispmax=200
Note: Don't click on the above URL; instead copy and paste it into your browser's address box, then let your browser find this URL address.
Summary: Research has shown that flupenthixol is just as effective as an antipsychotic medication as risperidone, olanzapine, haloperidol, and fluphenazine decanoate. Unlike risperidone and olanzapine, flupenthixol does not cause significant weight gain.
Low dose flupenthixol has been shown to be an effective antidepressant medication. As such, it is the only depot antidepressant medication currently available (i.e., an injection lasts 14 days).
1: Psychiatr Prax. 2004 Nov;31 Suppl 1:S167-9.
[Incidence of rigor during treatment with flupentixol decanoate in comparison to risperidone]
[Article in German]
Scherer J, Dobmeier P, Kuhn K, Schmaus W.
Klinik des Bezirks Oberbayern am Klinikum Garmisch-Partenkirchen. josef.scherer@psychiatrie-gap.de
STUDY OBJECTIVE: We investigated as to whether dosedependent extrapyramidal tolerance of Flupentixol decanoate is inferior to that of Risperidone. METHOD: 143 Risperidone and 177 Flupentixol decanoate treated patients were consecutively entered into this non - randomized open study and assessed with the Simpson-Angus-Scale regarding presence of rigor. Treatment comparisons of rigor frequency was done by Kaplan-Meier analysis. RESULTS: The risk of rigor increased with dose on both treatments. EPMS-risk was not increased under treatment with Flupentixol decanoate (mean dose 35.06 19.7 mg/2 weeks) compared to Risperidone (mean daily dose: 5.2 2.5 mg/kg) when comparable weight standardized Haloperidol equivalence doses (WHE) were used. CONCLUSION: This study offers limited evidence for methodological reasons. Yet, results do not support the view that EPS are more frequent on Flupentixol decanoate than on Risperidone when doses are comparable.
Publication Types: Clinical Trial Comparative Study English Abstract
PMID: 15570542 [PubMed - indexed for MEDLINE]
2: Pharmacopsychiatry. 2004 Nov;37(6):279-85.
Olanzapine versus flupenthixol in the treatment of inpatients with schizophrenia: a randomized double-blind trial.
Gattaz WF, Diehl A, Geuppert MS, Hubrich P, Schmitt A, Linde I, Maras A, Dittmann RW.
Department and Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), Faculty of Medicine, University of Sao Paulo, Rua Dr. Ovidio Pires de Campos s/n, PO Box 3671, 05403-010 Sao Paulo, Brazil. gattaz@usp.br
OBJECTIVE: The atypical antipsychotic olanzapine has extensively been compared with haloperidol, whereas studies vs. other (conventional) neuroleptics are scarce. This exploratory double-blind 4-week study was designed to compare the efficacy and the safety of olanzapine (OLA) and flupenthixol (FLU) which have recently been considered as a "partially atypical" antipsychotics. METHODS: Twenty-eight inpatients with schizophrenia (DSM-IV) were randomly assigned for treatment with OLA (N = 15, 5-20 mg/d) or FLU (N = 13, 5-20 mg/d). The Brief Psychiatric Rating Scale (BPRS) and the Negative Symptoms Rating Scale (NSRS), plus the Patient Global Impression (PGI) and Clinical Global Impression (CGI) scales, were used to assess the efficacy of both compounds; safety was determined by using the Simpson Angus Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS) and by assessing treatment-emergent adverse events. Non-parametric statistics were applied. RESULTS: BPRS and NSRS scores improved in both groups (exploratory tests; all p < or = 0.02). Similar results were observed for CGI-Severity, CGI- and PGI-Improvement. There were no significant group differences. Responder rates (at least 40 % decrease in BPRS total) were 9/13 OLA patients (69 %) and 9/12 FLU patients (75 %). EPS events were reported only in the FLU group (p < 0.01); FLU patients needed significantly more anticholinergic medication. Weight gain was higher in OLA patients (p < 0.01). Overall, fewer patients with adverse events were observed in the OLA group (p = 0.04). No significant changes were noted on SAS and AIMS scores. CONCLUSION: Findings from this study suggest that overall and negative symptomatology improved in both treatment groups, while the safety and tolerability profiles differed for both substances.
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 15551194 [PubMed - indexed for MEDLINE]
3: Fortschr Neurol Psychiatr. 2004 Jul;72(7):397-403.
[Quality of life and therapeutic result in outpatients with schizophrenia under flupenthixol treatment]
[Article in German]
Kuhn KU, Quednow BB, Landen H, Riedel M, Thiel M.
Universitat Bonn, Klinik fur Psychiatrie und Psychotherapie, Bonn. k.u.kuehn@uni-bonn.de
The objective of this phase IV surveillance study was to document the efficacy and tolerability of flupenthixol as well as the quality of life of patients suffering from schizophrenia and to gain insights into which doses were actually used in specialists outpatients care. The observational variables in this study include demographic variables, details of the diagnosis as well as concomitant diseases. Further evaluations included the assessment of CGI-Scale and subjective patient quality of live assessment using a standardised questionnaire. This questionnaire SWN-K (subjective well-being under neuroleptic treatment; short version) includes 20 items on the state of health with a six-point scale from "absolutely not" to "very strong" respectively. 66.3 % Patients were treated with the depot form of flupenthixol, the rest with oral medication with mean doses of 9.2 mg/d i. m. and 6.3 mg/d p. o. respectively. 78.8 % of patients improved on the CGI-Scale, 5.5 % had an adverse event and in 4.6 % of patients this event was related to the medication. 0.3 % of patients had a serious adverse event. The mean of SWN-K improved from 61.2 to 78.5 in the course of study. The CGI improved from 5.83 to 3.43 in the course of treatment.
Publication Types: English Abstract
PMID: 15252753 [PubMed - indexed for MEDLINE]
4: Psychiatr Prax. 2003 May;30 Suppl 2:S94-6.
[Comparative effectiveness of flupenthixol and risperidone on negative symptoms of schizophrenia]
[Article in German]
Philipp M, Lesch OM, Schmauss M, Dose M, Glaser T.
Bezirkskrankenhaus Landshut, Prof.-Buchner-Strasse 22, 84034 Landshut.
The efficacy of flupentixol and risperidone were compared in a randomized double-blind study in 153 chronic schizophrenic patients. Flupentixol showed to be not inferior to risperidone concerning schizophrenic negative symptoms at week 8, 16 and 24. Positive symptoms and general psychopathology improved comparably, too. There was a trend in favor of flupentixol concerning the improvement of depressive symptoms and a trend in favor of risperidone concerning the improvement of preexisting parkinsonian symptoms. The study data justify to regard flupentixol as a "partial atypical" antipsychotic.
Publication Types: Clinical Trial Comparative Study English Abstract Multicenter Study Randomized Controlled Trial
PMID: 14509050 [PubMed - indexed for MEDLINE]
5: Eur Addict Res. 2003 Apr;9(2):65-72.
Flupenthixol in relapse prevention in schizophrenics with comorbid alcoholism: results from an open clinical study.
Soyka M, Aichmuller C, v Bardeleben U, Beneke M, Glaser T, Hornung-Knobel S, Wegner U.
Psychiatric Hospital University of Munich, Munich, Germany. Michael.Soyka@psy.med.uni-muenchen.de
Substance use, especially alcoholism, has been recognized as a significant problem in schizophrenic patients, though only a few studies on the effects of pharmacotherapy in these patients have been conducted so far. The thioxanthene neuroleptic flupenthixol, which can be given intramuscularly (i.m.) for improving compliance, has been studied as a possible anti-craving drug both in animal models of alcoholism and some clinical studies. Pilot studies suggest that comorbid schizophrenics with substance use may benefit from treatment with flupenthixol. Efficacy of flupenthixol (10-60 mg i.m.) in reducing alcohol consumption of dual diagnosis patients was studied in an open 6-month clinical trial in 27 schizophrenics with comorbid alcoholism. Twenty-one patients entered the intention-to-treat analysis. Fourteen subjects were completers, 13 dropped out. Six patients completely abstained from alcohol during treatment. Alcohol consumption was significantly reduced compared to baseline (4 weeks before treatment as measured by timeline follow-back interview). In general, while patients showed a marked improvement concerning alcohol consumption, only a slight improvement in psychopathology was recorded. Overall tolerability was good. These data indicate a probable beneficial effect of flupenthixol in schizophrenic patients with comorbid alcoholism. Although the efficacy of flupenthixol as an anti-craving drug in dual diagnosis patients has to be explored in further studies, the drug may be considered a promising medication for these patients. Copyright 2003 S. Karger AG, Basel
Publication Types: Clinical Trial Comparative Study Evaluation Studies Multicenter Study
PMID: 12644732 [PubMed - indexed for MEDLINE]
6: Neuropsychobiology. 2003;47(1):37-46.
Flupenthixol versus risperidone: subjective quality of life as an important factor for compliance in chronic schizophrenic patients.
Hertling I, Philipp M, Dvorak A, Glaser T, Mast O, Beneke M, Ramskogler K, Saletu-Zyhlarz G, Walter H, Lesch OM.
Department of Psychiatry, University of Vienna, Wahringer Gurtel 18-20, A-1090 Vienna, Austria.
OBJECTIVE: The primary aim of this paper was to compare the effects of flupenthixol and risperidone on subjective quality of life and attitude towards medication in chronic schizophrenic patients with mainly negative symptoms. In a spectrum ranging from its typical end "haloperidol" to its atypical end "clozapine", flupenthixol has typical and atypical characteristics. METHODS: The effects of flupenthixol versus risperidone were investigated in a multicenter, double-blind trial, whereas subjective quality of life was assessed by means of the EuroQuol-Visual Analogue Scale and the patient satisfaction questionnaire. The attitude towards medication was assessed by means of the Drug Attitude Inventory-30 (DAI-30). RESULTS: Mean daily dose of study medication was 6.6 (SD 2.9) mg/day flupenthixol and 3.6 (SD 1.2) mg/day risperidone. Both groups showed a significant improvement regarding subjective quality of life and positive attitude towards medication. Especially the categories "control of their thoughts", concentration and "feeling better in general" ameliorated in both groups. In the flupenthixol group, the "ability to cope with stress", "feel more relaxed" and the "ability to achieve something" improved significantly more than in the risperidone group. CONCLUSIONS: (1) The spectrum of schizophrenia can be treated effectively with different neuroleptic treatments. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. (3) Subjective quality of life significantly increased with no difference between the groups. Copyright 2003 S. Karger AG, Basel
Publication Types: Clinical Trial Multicenter Study Randomized Controlled Trial
PMID: 12606844 [PubMed - indexed for MEDLINE]
7: Fortschr Neurol Psychiatr. 1998 Oct;66(10):442-9.
[Positive and negative symptoms in chronic schizophrenic patients under maintenance therapy with flupenthixol decanoate for a twelve month perioid]
[Article in German]
Pach J, Finkbeiner T, Glaser T, Haug J, Osterheider M, Tegeler J.
Psychiatrische Klinik, Kliniken Essen-Mitte.
62 chronic schizophrenics, who after a psychotic exacerbation were stabilized again, were randomized on 3 different maintenance dosages of flupentixol-decanoate and observed for 12 months. 15 (24.2%) patients had a relapse independently of the dose. 34 of the 47 patients without relapse had complete documentations of the follow-up. After 3 to 6 months there was an obvious and constant clinical improvement as assessed by various test inventories. The BPRS-scores for psychopathology, negative and positive symptoms improved significantly between 14 to 18%. There was also significant reduction of negative symptoms assessed by SANS (22%) as well in the severity of illness (CGI) and an amelioration of psychosocial functioning (GAS, Strauss-Carpenter). At the end of trial 26.4% of the patients had mild involuntary movements (AIMS), 23.5% were on antiparkinson-medication. It is concluded that there could be an indication for flupentixol-decanoate in the long term maintenance therapy especially of chronic schizophrenics with negative symptoms and problems of compliance under oral medication.
Publication Types: Clinical Trial English Abstract Multicenter Study Randomized Controlled Trial
PMID: 9825249 [PubMed - indexed for MEDLINE]
8: Eur Neuropsychopharmacol. 1997 Nov;7(4):261-6.
Tolerability of low dose neuroleptics: a case control study of flupenthixol.
Fritze J, Spreda I.
Klinik fur Psychiatrie und Psychotherapie I, Zentrum der Psychiatrie, Johann Wolfgang Goethe-Universitat, Frankfurt am Main, Germany.
There are no data available on the risk of extrapyramidal symptoms when using long-term flupenthixol in low dosage in patients suffering from anxiety and depressive disorders. In a case control study 106 patients essentially treated with the neuroleptic flupenthixol in a so-called low, non-antipsychotic dosage were compared to n=37 otherwise comparable patients who never had been treated with neuroleptics. The investigator was blind to the previous treatment conditions. Extrapyramidal symptoms were found although with a low prevalence and mild degree: 6.7% tardive dyskinesia, none in controls; pseudoparkinsonism 26%, 16% in controls. Extrapyramidal side-effects, especially tardive dyskinesia, have to be considered in the individual weighing of therapeutic benefits and risks even when prescribing flupenthixol in low dosages.
Publication Types: Comparative Study
PMID: 9443657 [PubMed - indexed for MEDLINE]
9: Pharmacotherapy. 1991;11(6):450-9.
Antidepressant effects of flupenthixol.
Gruber AJ, Cole JO.
Affective Disease Program, McLean Hospital, Belmont, Massachusetts 02176.
Strong evidence exists that flupenthixol, not presently distributed in the United States, is an effective antidepressant. Its advantages over available antidepressants include its safety with respect to overdose and in combination with other medications, low dependency risk, rapid onset of action, and availability in depot preparation. Flupenthixol also may be useful as a mood elevator for schizophrenics, an alternative mood stabilizer for patients with bipolar disease, and a facilitator for cocaine withdrawal.
Publication Types: Clinical Trial Review
PMID: 1771144 [PubMed - indexed for MEDLINE]
10: Curr Med Res Opin. 1990;12(3):191-7.
Depression in general practice: a comparison of flupenthixol dihydrochloride and dothiepin hydrochloride.
Dwivedi VS, Berger AB, Khong TK, Hamilton BA, Jones PG, Brantingham P, Grillage MG, Prasad S, Kundu BN, Renwick JA, et al.
A single-blind, parallel group, general practice study was carried out in 153 patients with mild to moderate depression to compare the efficacy and tolerability of flupenthixol dihydrochloride and dothiepin hydrochloride. Patients were allocated at random to receive single daily doses of either 1 mg flupenthixol in the morning or 75 mg dothiepin in the evening, and this dose could be doubled at the end of 2 weeks in the event of inadequate response. Assessments were made on entry and after 1, 2, 4 and 6 weeks of treatment using the Hamilton Depression Rating Scale, a 4-point severity scale and an unwanted symptoms checklist. The results showed that both treatments significantly improved the patients' condition over 6 weeks, and there was a significant difference in favour of flupenthixol at end-point. Both drugs were well tolerated, although persistence of anticholinergic side-effects in the dothiepin group resulted in a trend favouring flupenthixol. One patient in the flupenthixol group attempted suicide by overdose but made a complete recovery.
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 2272193 [PubMed - indexed for MEDLINE]
11: Curr Med Res Opin. 1990;12(1):51-7.
A double-blind comparison of oral amitriptyline and low-dose intramuscular flupenthixol decanoate in depressive illness.
Maragakis BP.
Department of Psychological Medicine, Billinge Hospital, Wigan, England.
Fifty-seven hospital out-patients with depressive symptoms were studied in a double-blind manner for up to 4 weeks, 30 whilst being treated with intramuscular flupenthixol decanoate (5 to 10 mg/fortnight) and 27 with oral amitriptyline (75 to 150 mg/day). The results of assessment using the Hamilton Rating Scale for Depression, the Leeds Self-Rating Scale for Depression and the Clinical Global Impressions severity scale showed that both therapies were effective in resolving depression in the patients studied. The two treatments were well tolerated and side-effect profiles were similar, dry mouth, faintness/dizziness and drowsiness being the most frequently reported adverse events. Extrapyramidal signs were seen in similar numbers of patients in each treatment group. One patient from each of the two groups was withdrawn from therapy before the end of the study because of adverse events.
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 2188797 [PubMed - indexed for MEDLINE]
12: Curr Med Res Opin. 1989;11(9):593-9.
Primary care treatment of depression in the elderly: a double-blind, multi-centre study of flupenthixol ('Fluanxol') and sustained-release amitriptyline.
Hostmaelingen HJ, Asskilt O, Austad SG, Fjellheim J, Hostmaelingen EA, Kristiansen PH, Olsen TI, Skotte T, Ofsti E.
A multi-centre general practice study was carried out to compare flupenthixol and a sustained-release preparation of amitriptyline in the primary care treatment of depression in the elderly. Fifty-one clinically depressed patients, aged 65 years or over, were allocated at random to one of the two treatment groups in this 4-week double-blind, double-dummy study. On entry, patients received either a 0.5 mg flupenthixol tablet in the morning and a placebo capsule at night (25 patients) or a 25 mg sustained-release amitriptyline capsule at night and a placebo tablet in the morning (26 patients), but at the end of the first or second weeks the dosage could be doubled according to the assessed clinical need. Fourteen patients in each treatment group had their dosages doubled. Patient assessment was undertaken on study entry and after 1, 2 and 4 weeks of treatment using a 0 to 3 scale global assessment and the Montgomery Asberg Depression Rating Scale; side-effects were recorded on the UKU Scale. After 4-weeks' treatment, over 80% of patients in each group had improved and in the flupenthixol group there was additionally a noticeable and highly significant reduction in symptom severity after only 1 week of treatment. Patients treated with flupenthixol had fewer and milder side-effects.
Publication Types: Clinical Trial Comparative Study Multicenter Study Randomized Controlled Trial
PMID: 2692973 [PubMed - indexed for MEDLINE]
13: Pharmatherapeutica. 1989;5(5):292-7.
Flupenthixol and fluvoxamine in mild to moderate depression: a comparison in general practice.
Hamilton BA, Jones PG, Hoda AN, Keane PM, Majid I, Zaidi SI.
Seventy-two depressed patients attending general practices were randomly allocated to treatment with either flupenthixol dihydrochloride (1 to 2 mg/day) or fluvoxamine maleate (100 to 200 mg/day) to assess efficacy and side-effects over a 4-week period. Clinical assessments were carried out before medication (Day 1) and on Days 8, 15 and 29 of treatment using the Hamilton Rating Scale for Depression, Clinical Global Impressions (CGI) and a patient self-assessment visual analogue scale for depression. Unwanted symptoms were also recorded. Reduction in mean total scores on the Hamilton scale at each assessment and therapeutic effect improvement on the CGI were greater for patients treated with flupenthixol (p less than 0.05). Reduction in unwanted symptoms was progressive in both groups, but more pronounced in patients receiving flupenthixol. Twice as many new symptoms arose in the fluvoxamine group compared to the flupenthixol group. Four patients were withdrawn in the fluvoxamine group due to untoward drug effects compared with none in the flupenthixol group.
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 2501801 [PubMed - indexed for MEDLINE]
14: Acta Psychiatr Belg. 1987 May-Jun;87(3):260-6.
The psychopharmacology of borderline personality disorders.
Montgomery SA.
St Mary's Hospital Medical School, Academic Department of Psychiatry, London, Great-Britain.
DSM-III borderline personality disorder defines a group of patients who are characterised by impulsivity and unpredictable behaviour, inappropriate aggression, intense and unstable relationships and are often associated with repeated suicidal behaviour. A substantial body of research has established an association between disturbance of serotonin and also dopamine and suicidal behaviour in depression. A similar relationship is also seen in studies of personality disorders which suggests the association is not specific to depression. A placebo controlled study of low dose flupenthixol has been shown to significantly reduce subsequent suicidal behaviour in patients with personality disorders without depression or schizophrenia. Evidence points to a biological basis for suicidal behaviour and borderline personality disorder and possibly of pharmacotherapy.
PMID: 3673629 [PubMed - indexed for MEDLINE]
15: Pharmatherapeutica. 1986;4(9):561-70.
Neurotic depression accompanied by somatic symptoms: a double-blind comparison of flupenthixol and diazepam in general practice.
Grillage M.
A total of 192 patients suffering from mild to moderate depression, with or without anxiety, accompanied by one or more specific somatic symptoms, was entered into a double-blind, multi-centre trial to compare flupenthixol and diazepam as treatments for psychosomatic syndromes in general practice. Each patient was treated for 4 weeks and assessed after 1, 2 and 4 weeks on the Hamilton Depression Scale, with visual analogue scales of depression and somatic symptoms, by global assessments (psychological and somatic symptoms) and on a side-effects scale. The principal somatic symptoms were tension headache (69 patients), epigastric discomfort (59 patients), chest pain (39 patients) and backache (25 patients). There were 9 drop-outs (2 on flupenthixol and 7 on diazepam), of whom 5 (2 on flupenthixol and 3 on diazepam) who were treated for at least 2 weeks were included in the analysis of results. All patients received 1 tablet a day (0.5 mg flupenthixol or 2.5 mg diazepam) for the first week. Thereafter, all except 5 patients (3 on flupenthixol and 2 on diazepam) had their dose doubled for the remaining 3 weeks of study. Both drugs were effective in producing consistent improvement in all four somatic symptom groups in terms of both depression and somatic symptoms over the 4 weeks of study. There was a trend throughout in favour of flupenthixol as the more therapeutically effective. Flupenthixol was significantly more effective in relieving depressive symptoms and somatic symptoms in all four somatic symptom groups considered together. It was also superior to diazepam as measured by its effect on the depression sub-scales, anxiety, agitated depression, retarded depression and melancholia. Both drugs were well tolerated, although diazepam-treated patients showed a moderate increase in side-effects scores initially, while the scores in patients treated with flupenthixol decreased consistently over all 4 weeks of the trial. It is concluded from this study that flupenthixol has an important place in the management of patients with psychosomatic illness.
Publication Types: Clinical Trial Comparative Study Controlled Clinical Trial Randomized Controlled Trial
PMID: 3763651 [PubMed - indexed for MEDLINE]
16: Pharmatherapeutica. 1986;4(7):405-10.
A double-blind comparison of once-daily flupenthixol and mianserin in depressed hospital out-patients.
Majid I.
A double-blind, parallel group study was carried out in 51 mild to moderately depressed hospital out-patients to assess the therapeutic efficacy and side-effects of once-daily flupenthixol (1 mg) administered in the morning compared with once-daily mianserin (30 mg) administered in the evening. Patients were treated over a period of 6 weeks and assessments were made before and during treatment using the Newcastle Rating Scale, the Clinical Global Impression, the Hamilton Depression Scale, the Leeds Self-Rating Scale for Depression, and a check-list of side-effects. The results showed that 91% of flupenthixol patients and 80% of mianserin patients were assessed as 'normal' on completion of the study period. Depressive symptoms decreased progressively in both groups. Reports of side-effects in both groups showed a progressive reduction in number and severity during the study. The reduction at the end of the first week of treatment with mianserin was not as great as that seen with flupenthixol; reports of drowsiness accounted for most of the difference.
Publication Types: Clinical Trial Comparative Study Controlled Clinical Trial Randomized Controlled Trial
PMID: 3515368 [PubMed - indexed for MEDLINE]
17: J Int Med Res. 1984;12(1):17-22.
Therapeutic efficacy of flupenthixol decanoate in schizoaffective disorder: a clinical evaluation.
Singh AN.
The present open study was undertaken to evaluate the therapeutic efficacy and side-effects of flupenthixol, a thioxanthene derivative in the treatment of schizoaffective psychosis. A total of twenty in-patients, selected according to specific research criteria were treated with flupenthixol (20 mg to 60 mg i.m. q.2.weeks) for a period of 6 months. During the course of the study, a detailed battery of psychiatric rating scales was completed prior to the commencement of the treatment and at regular intervals thereafter. Additionally, detailed physical examinations and laboratory tests were also carried out at regular intervals. Results show that fifteen patients improved significantly, two patients remained unchanged while three patients deteriorated and were discontinued. Adverse effects were minimal and limited to tremor and akathisia. The present study highlights the usefulness of flupenthixol as a monotherapy in the management of schizoaffective psychosis.
PMID: 6692965 [PubMed - indexed for MEDLINE]
18: J Clin Psychiatry. 1983 Oct;44(10):369-71.
Depressive symptoms in chronic schizophrenic patients after withdrawal of long-acting neuroleptics.
Wistedt B, Palmstierna T.
A double-blind randomized investigation compared withdrawal (placebo) with continued use of long-acting neuroleptics (fluphenazine decanoate or flupenthixol decanoate) in 41 chronic schizophrenic outpatients. After 6 weeks there was a tendency toward higher depressive scores in the placebo group, a difference which became statistically significant (p less than .05) at week 24. These results do not support earlier observations that neuroleptic drugs cause depression. Further analyses of the data indicated that depressive symptomatology could be an early sign of relapse.
Publication Types: Clinical Trial Randomized Controlled Trial
PMID: 6643398 [PubMed - indexed for MEDLINE]
19: Acta Psychiatr Scand. 1983 Jun;67(6):378-88.
Comparative double-blind study of flupenthixol decanoate and fluphenazine decanoate in the treatment of patients relapsing in a schizophrenic symptomatology.
Wistedt B, Ranta J.
Thirty-two chronic schizophrenics who had relapsed entered a double-blind randomised study and were followed-up for 2 years with the intention of measuring any difference in therapeutic effect and side effects between flupenthixol decanoate and fluphenazine decanoate. No differences could be seen as regards the global effect or the effect on the schizophrenic symptomatology during the first 6 months. After 1 year of treatment flupenthixol decanoate showed a trend towards a better effect on schizophrenic symptomatology. A corresponding result was seen for the depressive symptoms. There were no differences in the appearance of side effects. The need for additional neuroleptics in the initial phase seemed to be identical for both drugs. A possible slow antipsychotic effect with flupenthixol decanoate is probably due to the administered dose being somewhat low (in the present study approximately 31 mg flupenthixol corresponding to 27 mg fluphenazine). This suggests that flupenthixol should have been given in a somewhat higher dose (25 mg fluphenazine decanoate corresponding to 40 mg flupenthixol decanoate).
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 6349256 [PubMed - indexed for MEDLINE]
20: Acta Psychiatr Scand. 1983 May;67(5):339-52.
The discontinuance of maintenance neuroleptic therapy in chronic schizophrenic patients: drug and social consequences.
Johnson DA, Pasterski G, Ludlow JM, Street K, Taylor RD.
In a prospective follow-up the outcome of 60 chronic schizophrenic patients who discontinued neuroleptic therapy after remaining stable 12-48 months was compared with controls continuing medication. Not only did the drug-discontinued patients have more relapses (P less than 0.001), but the form of relapse was both more severe and acute, resulting in differences of self-injury (P less than 0.05), anti-social behaviour (P less than 0.01), inpatient admissions (P less than 0.001), and the use of compulsory powers (P less than 0.01). In patients who relapsed, both social and work function was affected adversely for some months. Patients who remained relapse-free without drugs (20%) had a level of work and social function similar to medicated patients. At the end of 18 months the patients who discontinued depot maintenance therapy were found to have been prescribed one-third more neuroleptic drugs than controls, with a possible increase in the risk of long-term tardive dyskinesia.
PMID: 6135298 [PubMed - indexed for MEDLINE]
21: Pharmatherapeutica. 1983;3(5):354-64.
Flupenthixol versus haloperidol in acute psychosis.
Parent M, Toussaint C.
Forty acutely psychotic patients were treated either with flupenthixol drops or haloperidol drops in an open, 28-day controlled study. The flupenthixol group comprised 11 schizophrenic, 8 manic, and 1 paranoid patient and there were 10 schizophrenic, 5 manic, and 5 paranoid patients in the haloperidol group. Mean daily dosage was approximately 112 mg flupenthixol and 18 mg haloperidol. Clinically, both drugs showed an antipsychotic effect. In the schizophrenic patients there was a definite trend towards a more rapid relief of the psychotic symptoms after flupenthixol treatment. In contrast to haloperidol, flupenthixol showed a mood elevating effect and an effect on the negative symptoms, e.g. emotional withdrawal, motor retardation, blunted affect, and disorientation. With both drugs, the most troublesome side-effects were extrapyramidal in nature. Initially, they were more common in the flupenthixol group: later the incidence was similar.
Publication Types: Clinical Trial Controlled Clinical Trial
PMID: 6844372 [PubMed - indexed for MEDLINE]
22: Neuropsychobiology. 1983;10(2-3):131-6.
Depression-inducing and antidepressive effects of neuroleptics. Experiences with flupenthixol and flupenthixol decanoate.
Poldinger W, Sieberns S.
The antidepressive and anxiolytic efficacy of flupenthixol has been investigated in numerous controlled and open trials involving patients with endogenous, reactive as well as senile depressions. When administered at a mean daily single or multiple dose of 1-2 mg, flupenthixol proved to be a very effective and well-tolerated antidepressant. As opposed to some of the currently available antidepressants, flupenthixol has a rapid onset of action which is often displayed within the first 2-3 days following its application. Flupenthixol decanoate has also a pronounced antidepressive and anxiolytic effect which appears to be adequate enough for treating mild to moderately severe syndromes of depression. This depot neuroleptic has been given at a fortnightly dosage ranging between 2.5 and 30 mg. However, if the aspect of efficacy in relation to tolerance has to be taken in to consideration, then 5 mg are apt to be an appropriate dose. Patients with an agitated depression and/or suicide ideation should, however, be excluded from therapy with this drug. Extrapyramidal movement disorders which may appear during treatment are a disadvantage of this medication. Apparently such disorders are rarely encountered if the dose is kept below 10 mg. Other untoward effects are very seldom indeed. A final and conclusive judgement on the possible application of flupenthixol decanoate in the prophylaxis of phases in patients with bipolar and periodical depressions is as yet not feasible. Further clinical trials are necessary before flupenthixol decanoate can be classified as a possible 'depot antidepressant'.
Publication Types: Comparative Study
PMID: 6674820 [PubMed - indexed for MEDLINE]
23: Br J Psychiatry. 1982 Mar;140:287-91.
A controlled comparison of flupenthixol decanoate injections and oral amitriptyline in depressed out-patients.
Tam W, Young JP, John G, Lader MH.
Sixty-eight depressed out-patients were allocated to treatment with either oral amitriptyline (75-225 mg/day) or intramuscular flupenthixol decanoate (10-30 mg every 14 days) in flexible dosage for 12 weeks under double-blind procedures. Various observer- and self-rating scales were applied before and after 2, 4, 8 and 12 weeks of treatment. Twenty-four patients completed the course of amitriptyline and 20 the course of flupenthixol. All variables improved over time, but there were no significant differences between the two drugs. The Newcastle scores pre-treatment were not related to drug response suggesting that both drugs were similarly effective across a wide spectrum of depressive disorders. Patients on amitriptyline tended to complain of dry mouth; those on flupenthixol had a higher incidence of extrapyramidal signs, the majority receiving anti-parkinsonian drugs at some time during the treatment. Flupenthixol decanoate in low dose is a useful anti-depressant, but should be restricted to short courses of treatment, to patients refractory to other treatments, and to patients suspected of poor compliance.
Publication Types: Clinical Trial Controlled Clinical Trial
PMID: 7093597 [PubMed - indexed for MEDLINE]
24: Acta Psychiatr Belg. 1982;82(6):617-31.
[Flupenthixol versus haloperidol in acute psychotic episodes]
[Article in French]
Parent M, Toussaint C.
The aim of this study is to evaluate the activity of flupentixol oral high concentration and to define the profile of the drug according to the administered dose. The trial includes 40 acute patients (21 schizophrenics, 13 manic patients and 6 other psychotics). The study was open, but the patients were treated at random either by haloperidol or by flupentixol. Both substances showed a strong antipsychotic and antimanic effect. The differences according to the administered doses were: a quicker onset of action for flupentixol in schizophrenic patients; a more pronounced activity of flupentixol in the same patients, as far as anxiety, depressive tendencies and defect symptoms are concerned. Extrapyramidal side effects are the most common ones amongst the two drugs.
Publication Types: Clinical Trial Comparative Study English Abstract Randomized Controlled Trial
PMID: 7183131 [PubMed - indexed for MEDLINE]
25: Acta Psychiatr Scand. 1981 Sep;64(3):226-37.
Flupenthixol decanoate in recurrent manic-depressive illness. A comparison with lithium.
Ahlfors UG, Baastrup PC, Dencker SJ, Elgen K, Lingjaerde O, Pedersen V, Schou M, Aaskoven O.
The hypothesis that flupenthixol decanoate may serve as an alternative to prophylactically administered lithium in recurrent manic-depressive illness, bipolar and unipolar type, was tested in two groups of patients. In Group I the patients were allocated randomly to maintenance treatment with either lithium or flupenthixol decanoate. The patients in Group II had previously been given lithium and were switched to flupenthixol decanoate because of unsatisfactory prophylactic effect of lithium, doubtful tablet compliance, troublesome side effects, or fear of later harmful effects. The flupenthixol decanoate dosage was 20 mg every 2-3 weeks. The study was not blind. In Group I neither lithium treatment (14 patients) nor treatment with flupenthixol decanoate (19 patients) led to a significant fall of mean episode frequency or mean per cent time ill. The reasons for this lack of response are not clear, but prognostically negative selection of the patients presumably took place before and possibly also during the hospitalization. Since absent effects cannot be compared, this part of the trial remains inconclusive. In Group II (93 patients) treatment with flupenthixol decanoate was associated with significant falls of the frequency of manic episodes and per cent time ill in mania and with significant rises of the frequency of depressive episodes and per cent time ill in depression. Increase of depressive morbidity was seen only in patients who had been given lithium during the pre-trial period and was presumably a result of the discontinuation of lithium. It is not known whether flupenthixol decanoate is of value in the prophylactic treatment of recurrent manic-depressive illness, but the drug may be worth trying in patients whose disease is dominated more by manic than by depressive recurrences and who do not respond to lithium or do not tolerate it or do not take it.
Publication Types: Clinical Trial Comparative Study Randomized Controlled Trial
PMID: 7324992 [PubMed - indexed for MEDLINE]
26: Acta Psychiatr Scand. 1981 Jul;64(1):65-84.
A depot neuroleptic withdrawal study. A controlled study of the clinical effects of the withdrawal of depot fluphenazine decanoate and depot flupenthixol decanoate in chronic schizophrenic patients.
Wistedt B.
A double-blind withdrawal trial in 41 chronic schizophrenic outpatients on neuroleptics was carried out during 6 months. Long-acting neuroleptics (fluphenazine decanoate or flupenthixol decanoate) were used in comparison with placebo to determine the value in maintenance therapy. Most patients had a rather low maintenance dose, about 12.5-25 mg fluphenazine decanoate or 20-40 mg flupenthixol decanoate every third week. Relapse was often characterized by a return of the dame symptoms as the patient had during his first schizophrenic attack. Drugs were significantly more effective than placebo in preventing relapse and readmission to hospital. 62% relapsed in the placebo groups as compared with 27% in the drug group. All patients on active substance and without relapse during the controlled study had their treatment discontinued for 24 months in an open follow-up investigation. This resulted in relapse of all patients but one, i.e. a final relapse frequency of 97%. A significant weight decrease was observed in the placebo group. The risk of withdrawal is discussed.
Publication Types: Clinical Trial
PMID: 7032224 [PubMed - indexed for MEDLINE]
27: Curr Med Res Opin. 1981;7(8):543-9.
Once daily flupenthixol in the treatment of elderly depressed patients: a multi-centre trial in general practice.
Valle-Jones JC, Swarbrick DJ.
Ninety-five elderly depressed patients were entered into an open trial of 0.5 to 1.0 mg flupenthixol dihydrochloride, as a single daily dose in the morning. Eighty-seven patients were treated and assessed for 14 days, 6 patients failed to attend follow-up appointments and 2 patients were withdrawn from the trial because of acute physical illness. After 14-days' treatment, a decrease in the severity of the illness was recorded on the Clinical Global Impression Scale in 77% of the patients, and statistically significant improvements were noted in the 5 individually rated symptoms of lowered mood, fatigue, tendency to weep, feelings of inadequacy and irritability. The number and severity of adverse effects recorded on a check-list decreased during the treatment period. The results suggest that flupenthixol is an effective antidepressant and is well tolerated by the elderly as a single daily dose.
Publication Types: Clinical Trial
PMID: 7030638 [PubMed - indexed for MEDLINE]
28: Br J Psychiatry. 1979 Dec;135:515-23.
Depressive and extrapyramidal symptoms and clinical effects: a trial of fluphenazine versus flupenthixol in maintenance of schizophrenic out-patients.
Knights A, Okasha MS, Salih MA, Hirsch SR.
Fifty-seven patients with a diagnosis of schizophrenia were started on either fluphenazine decanoate or flupenthixol decanoate injections in a double-blind trial just prior to discharge into the community. During the six month follow-up 30 per cent dropped out of the treatment. Of those observed for six months, 7 per cent relapsed, 54 per cent experienced depressive symptoms and 88 per cent extrapyramidial side-effects. Analysis of both clinical data and the ratings failed to discriminate between the two drugs.
Publication Types: Clinical Trial Comparative Study Controlled Clinical Trial
PMID: 394794 [PubMed - indexed for MEDLINE]
29: Acta Psychiatr Scand. 1979 Oct;60(4):313-22.
A double-blind comparison of flupenthixol decanoate and fluphenazine decanoate in the treatment of chronic schizophrenia.
Pinto R, Bannerjee A, Ghosh N.
Sixty-four chronic stabilised schizophrenics were studied for 18 months in order to assess the possible difference in therapeutic effects and side effects between flupenthixol decanoate and fluphenazine decanoate. Although certain differences in the BPRS sub-scores in favour of flupenthixol were present at various stages in the study, there was no significant difference between the two drugs in the overall antipsychotic scores at the end of the assessment period; however, more patients on fluphenating required additional therpay for depression or anxiety during the trial period.
Publication Types: Clinical Trial Comparative Study Controlled Clinical Trial
PMID: 390972 [PubMed - indexed for MEDLINE]
30: Br J Psychiatry. 1979 Aug;135:175-9.
High dose flupenthixol decanoate in chronic schizophrenia.
McCreadie RG, Flanagan WL, McKnight J, Jorgensen A.
In a double-blind trial, female 'drug-resistant' chronic schizophrenic in-patients were given high dose or standard dose flupenthixol decanoate for 13 weeks. Plasma flupenthixol levels showed a five-fold interindividual variation, but were consistently higher with the high dose. Analysis of final scores showed no statistically significant differences between groups with regards to mental state, ward behaviour and extrapyramidal side-effects. When compared with pre-trial scores, the extrapyramidal side-effects worsened significantly in the high dose patients and social withdrawal decreased in the standard dose patients. The mental state of a sub-group of patients, possibly drug resistant for pharmacokinetic reasons, improved significantly on the high dose over the 13 weeks.
Publication Types: Clinical Trial Controlled Clinical Trial
PMID: 387151 [PubMed - indexed for MEDLINE]
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